IntroductionPulmonary aspergilloma is the most common human disease caused by saprophytic species of the genus Aspergillus (1,2). It involves the formation of a fungus ball or mycetoma. Antifungal agents are usually ineffective and a cure can be achieved only with surgical treatment (1,3,4). Patients with an aspergilloma require surgical treatment because there is a risk of sudden life-threatening hemoptysis, and alternative medical treatments are usually ineffective. However, the surgical indications remain controversial because of the high incidence of postoperative complications (1,5,6).This retrospective study analyzed the clinical presentation, underlying lung disease, surgical indications, techniques, treatment outcomes, and postoperative complications of pulmonary aspergilloma. Materials and methodsWe operated on 77 patients for pulmonary aspergilloma between January 2000 and December 2013. The medical records were reviewed to determine the patients' history, clinical presentation, underlying lung disease, indications for surgery, surgical procedures, and postoperative complications. The subjects included 53 males (mean age: 44.26 (range: 10-73) years) and 24 females (mean age: 48.25 (range: 26-70) years).The patients were diagnosed based on history and radiological findings on a posteroanterior lung X-ray or computed tomography. We classified the lesions as simple pulmonary aspergilloma (SPA) if the lesion was welllocalized, with a thin-walled cavity smaller than 5 cm and little or no surrounding atelectasis or consolidated areas. Lesions were classified as complex pulmonary aspergilloma (CPA) if they were well-localized, thin-walled cavities larger than 5 cm or with thick walls, and surrounded by parenchymal sequelae as disseminated consolidation and atelectasis resulting from underlying lung disease, such as bronchiectasis or tuberculosis in most cases (Figure 1) (7-11).Background/aim: This retrospective study evaluated the clinical presentation, underlying lung disease, surgical indications, technique, treatment outcomes, and postoperative complications of pulmonary aspergilloma. Materials and methods:We evaluated 77 patients who underwent pulmonary resection of an aspergilloma at Atatürk Chest Diseases and Thoracic Surgery Research and Training Hospital between January 2000 and December 2013. The initial operations were 4 pneumonectomies, 24 lobectomies, 9 lobectomy plus myoplasties, 10 segmental resections, and 30 wedge resections. Six reoperations were carried out to deal with postoperative complications: 1 myoplasty, 2 completion lobectomies plus myoplasties, 2 myoplasties with rib resections, and 1 completion lobectomy. Results:The subjects comprised 53 males (mean age: 44.26 (range: 10-73) years) and 24 females (mean age: 48.25 (range: 26-70) years). The most common indication for surgery was hemoptysis in 52 patients (67.53%). The most common underlying lung disease was tuberculosis in 37 patients (48.05%). Forty patients (51.94%) had a simple pulmonary aspergilloma and 37 (48.05%) had a complex...

The internal jugular vein is an uncommon site of spontaneous venous thrombosis. Most cases usually result from intravenous drug abuse, jugular vein catheterisation, neck dissection, a hypercoagulable state associated with malignancy (Trousseau's syndrome), neck injury or ovarian overstimulation syndrome. In this paper, we present and discuss two cases of spontaneous jugular vein thrombosis associated with breast and lung malignancies. The possibility of Trousseau's syndrome due to distant malignancy should be considered by otolaryngologists and appropriately investigated.

No abstract

Isolation and identification of Avibacterium paragallinarum, the causative agent of infectious coryza, is considered a challenging task in laboratories with limited specialties. In the present study, 14 commercial layer fowls showing the typical symptoms of infectious coryza were subjected to primary isolation followed by polymerase chain reaction confirmation of suspect colonies (culture-PCR). Direct PCR assays on infraorbital sinus swab samples were also carried out. Thirty-five suspected cases of infectious coryza in commercial broiler chickens were also screened using direct PCR on infraorbital sinus swabs. In culture-PCR, only 1 of the 4 suspected isolates was confirmed as Av. paragallinarum. In comparison, in direct PCR, 5 layer samples were shown to be positive for Av. paragallinarum. All of the broiler samples were negative in the direct PCR assay. Our findings indicate that primary isolation in combination with PCR can be a simple method for diagnosis of infectious coryza, although with a lower sensitivity than direct PCR. While direct PCR is comparably the more rapid and sensitive test, there will be instances in which the bacterial isolate is needed for further use. Hence, the culture-PCR method can be a practical and simple approach, especially in laboratories with limited specialty in identification of this fastidious organism.

Background/aim: Pulmonary arteriovenous malformations (PAVMs) are direct communications between the branches of pulmonary arteries and veins. This study evaluates surgically treated cases of pulmonary arteriovenous malformations. Materials and methods:We retrospectively examined 41 cases of PAVM that were operated in our clinic between 1995 and 2012. We obtained the clinical, radiological, and surgical data of the patients from their files. Results:The 41 cases comprised 27 males and 14 females. Their mean age at diagnosis was 39.8 years (range: 9-71). The symptoms were hemoptysis in 28 cases, dyspnea in five, cough in three, and epistaxis in two; three patients were asymptomatic. Twenty-three right and 19 left posterolateral thoracotomies were performed, including one case which was operated bilaterally. Lower lobectomy was performed in 17 patients, lower lobectomy and lingulectomy in two, upper lobectomy in ten, middle lobectomy in two, segmentectomy in seven, and wedge resection in four. Postoperative histopathology was arteriovenous malformation in all cases. Conclusion:PAVMs are rare clinical conditions. Surgery remains the first choice when embolization treatment cannot be performed or is not successful, in symptomatic and complicated patients with PAVM, and/or in cases where the PAVM diagnosis cannot be established.